(TC17) Maxillary Cemento-osseous dysplasia: An uncommon clinical presentation and diagnostic challenge

Cemento-osseous dysplasia (COD) is a benign fibro-osseous lesion typically found in the mandibular anterior or posterior region. It’s characterized by the replacement of normal bone with fibrous tissue containing calcifications resembling cementum. This condition is often asymptomatic and is commonly discovered incidentally on routine dental radiographs. We present a unique case of COD in the maxilla, in a 27-year-old female who initially presented with dental sensitivity in the right maxillary quadrant. Clinical and radiographic examination revealed a radiolucent lesion which appeared to be associated with tooth #6, observed on both periapical imaging and cone-beam computed tomography (CBCT). Despite the lesion’s proximity to the tooth apex, sensibility testing demonstrated normal pulpal and periapical responses in all maxillary teeth, suggesting that the lesion was non-endodontic in origin. The diagnostic challenge necessitated surgical biopsy of the lesion. Histopathological examination revealed features that were supportive of a diagnosis of cemento-osseous dysplasia. This case report highlights the uncommon occurrence of COD in the maxilla, as well as the importance of differential diagnoses when clinical findings suggest a non-endodontic lesion. This case also underscores the need for careful evaluation in unusual presentations of benign bone lesions due to the variation in treatments based on the differential diagnosis.